The development of inhospital cost and cost-strucure for treatment of colon cancer in comparison to other solid and hematologic types of cancer in Germany 2010 – 2016

 

Introduction:

The German DRG-System (G-DRG) dataset was originally intended to serve for reimbursement as well as for quality assurance purposes. In the last 15 years the data were mostly used for hospital billing.

Target: This investigation should research whether the publicly available data allow the determination of total financial hospital efforts for colon cancer and the cost allocation within the hospital sector, plus the comparison with other types of tumors.

Methods:

The report browsers delivered by the German DRG Institute (InEK) were analyzed for cases of different types of cancer for 2010 and 2015. Statistical analysis was performed using Microsoft-Excel and Access (v 2013).

Results:

The total in hospital costs per hospital case, without special funding of some medications (Zusatzentgelt), were in 2015: € 3,913 (2010: € 3,387) for breast cancer, € 3,515 (€ 3,044) for lung cancer, € 5,010 (€ 4,039) for colon cancer, € 3,332 (€ 3,007) for Non-Hodgkin-Lymphoma (NHL) and € 10,395 (€ 8,959) for acute myeloid leukemia (AML). The personnel effort for physicians per case was € 935 (24% of total) for breast, € 719 (20%) lung, € 1,132 (23%) for colon, € 548 (16%) for NHL and € 1,507 (14%) for AML. From 2010 to 2015 the absolute and relative financial efforts for physicians increased, nursing care shrunk. The expenses for laboratory material per case were € 314 (8% of total) for breast, € 235 (7%) lung, € 272 (5%) for colon, € 506 (15%) for NHL and € 1,924 (19%) for AML. ICU efforts per case were € 34 (< 1% of total) for breast, € 180 (5%) lung, € 536 (10%) for colon, € 189 (6%) for NHL and € 2,888 (28%) for AML. There were 98,413 cases of breast cancer (-18% to 2010), resulting in total costs of € 385 m (-6% to 2010), 121,663 (-8%) cases of lung cancer (€ 426 m; +6%), 117,707 (-2%) cases of colon cancer (€ 590 m; +12%), 41,003 (+15%) cases of NHL (€ 137 m; +28%) and 10,616 (-30%) cases of AML (€ 110 m -18%).

Conclusion:

The data from the German DRG systems allow insights about the different financial efforts over time. Overall hospital costs for each disease Entity can be estimated. From the researched cancer types colon cancer needed most financial resources Overall, driven by high ICU expenditures. The influence of new technologies on effort patterns and costs could be measured.